Reduced number of circulating endothelial progenitor cells predicts future cardiovascular events -: Proof of concept for the clinical importance of endogenous vascular repair
Reduced number of circulating endothelial progenitor cells predicts future cardiovascular events -: Proof of concept for the clinical importance of endogenous vascular repair
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DOI：
10.1161/circulationaha.104.504340
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发表时间：
2005-06-07
期刊：
影响因子：
37.8
通讯作者：
Zeiher, AM
中科院分区：
文献类型：
--
作者：
Schmidt-Lucke, C;Rössig, L;Zeiher, AM
背景-内皮完整性的维持在预防动脉粥样硬化疾病进展中起着至关重要的作用。实验表明，内皮祖细胞 (EPC) 能够融入新血管形成部位，并成为内皮剥脱部位的所在地。因此，循环 EPC 可能提供内源性修复机制，以抵消持续的危险因素诱导的内皮损伤并替代功能失调的内皮。 方法和结果 - 在 120 名个体（43 名对照受试者、44 名稳定型冠状动脉疾病患者和 33 名急性冠状动脉综合征患者）中，循环 EPC 通过表面标记 CD34(+)KDR(+) 和 通过流式细胞术分析。心血管事件（心血管死亡、不稳定心绞痛、心肌梗塞、PTCA、CABG 或缺血性中风）作为中位随访 10 个月的结果变量。患有心血管事件的患者EPCs数量显着较低（P < 0.05）。根据 Kaplan-Meier 分析，EPC 数量减少与心血管事件发生率显着升高相关（P = 0.0009）。通过多变量分析，即使在调整了传统心血管危险因素和疾病活动度后，EPC 水平降低也是不良预后的显着独立预测因子（风险比，3.9；P < 0.05）。结论：循环 EPC 水平降低可独立预测动脉粥样硬化疾病进展，从而支持内源性血管修复在调节冠状动脉疾病临床过程中的重要作用。
Background-The maintenance of endothelial integrity plays a critical role in preventing atherosclerotic disease progression. Endothelial progenitor cells (EPCs) were experimentally shown to incorporate into sites of neovascularization and home to sites of endothelial denudation. Circulating EPCs may thus provide an endogenous repair mechanism to counteract ongoing risk factor-induced endothelial injury and to replace dysfunctional endothelium.Methods and Results-In 120 individuals (43 control subjects, 44 patients with stable coronary artery disease, and 33 patients with acute coronary syndromes), circulating EPCs were defined by the surface markers CD34(+)KDR(+) and analyzed by flow cytometry. Cardiovascular events (cardiovascular death, unstable angina, myocardial infarction, PTCA, CABG, or ischemic stroke) served as outcome variables over a median follow-up period of 10 months. Patients suffering from cardiovascular events had significantly lower numbers of EPCs (P < 0.05). Reduced numbers of EPCs were associated with a significantly higher incidence of cardiovascular events by Kaplan-Meier analysis ( P = 0.0009). By multivariate analysis, reduced EPC levels were a significant, independent predictor of poor prognosis, even after adjustment for traditional cardiovascular risk factors and disease activity (hazard ratio, 3.9; P < 0.05).Conclusions-Reduced levels of circulating EPCs independently predict atherosclerotic disease progression, thus supporting an important role for endogenous vascular repair to modulate the clinical course of coronary artery disease.